Healthcare Provider Details

I. General information

NPI: 1336349612
Provider Name (Legal Business Name): ELTON VERNARD SHULER MASTERS COUNSELING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5573 CAROLINA HIGHWAY
DENMARK SC
29042
US

IV. Provider business mailing address

2319 ST MATTHEWS ROAD
ORANGEBURG SC
29118
US

V. Phone/Fax

Practice location:
  • Phone: 803-793-4274
  • Fax: 803-793-4275
Mailing address:
  • Phone: 803-536-1571
  • Fax: 803-536-1463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: